Five Year Strategy

2019 - 2024 ‘Working to improve lives’

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Essex Partnership University NHS Foundation Trust (EPUT) was formed on 1 April 2017 following the merger of former North Essex Partnership University NHS Foundation Trust and former South Essex Partnership University NHS Foundation Trust. This strategy is our first full five year plan since the completion of the merger full business case. It sets out what we will achieve over the next five years including our key drivers in terms of national policy and supporting the development of health and social care across three Sustainability and Transformation Partnerships (STPs). Our strategy aims to align with the development path of each STP.

Our mission statement is:

Our purpose statement is:

In developing this strategy we engaged with the following groups of people to help us understand what is important to them when looking forward over the next five years, thank you to all who gave their time to support us in setting our agenda for the next five years:

Staff

The public

Service users

Carers

Council of Governors

STP Leads

‘A values based and trusted partner and advocate of mental and physical health’

‘To offer empowering and innovative person centred care and a place where people are proud to work’

Introduction

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EPUT provides community health, mental health and learning disability services for a population of approximately 1.3 million people throughout Bedfordshire, Essex, Suffolk and Luton. We employ 5,000 members of staff across 200 sites.

Our services include:

Mental health services

Community health services

Learning disabilities services

Social care

We provide a wide range of treatment and support to adults and older people experiencing mental illness both as inpatients and within the community. This includes; treatment, in secure and specialised settings. A number of our specialist services have achieved accreditation from the Royal College of Psychiatrists.

Our diverse range of community health services provide support and treatment to both adults and children. We deliver this care in community hospitals, health centres, GP surgeries and in our patients’ homes.

We provide support with inpatient services for learning disability teams, working in partnership with Hertfordshire Partnership University NHS Foundation Trust. As part of our a commitment to driving up quality in services for people with learning disabilities we are proud to say that we have signed up to the Driving Up Quality Code. Our self-assessment contains the full details of our commitment.

We provide personalised social care support to people with a range of needs, including people with learning disabilities or mental illness, supporting people to live independently.

About us

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We co-produced our vision and values with our staff and people with lived experience of our services. To illustrate our vision, values and strategic objectives we have produced the infographic below. This infographic will be used on all of our communications in order for people to be able to connect with what EPUT stands for.

Our Vision and Values

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We want our staff to provide the best possible care and service to our patients, service users, and their families and carers. Our Trust values are therefore underpinned by a set of behaviours we expect all staff to demonstrate while carrying out their work in the Trust.

Open

Compassionate Empowering

To be honest, accessible and responsive.

To understand different perspectives and take responsibility to respond appropriately to patients, carers and colleagues.

To go the extra mile and help others achieve their goals,

To work collaboratively with colleagues and all stakeholders and be open to new perspectives and ways of working.

To be friendly and courteous and show a caring and empathetic approach in transactions with others.

To encourage and embrace change and be proud to share their ideas,

To actively listen and have confidence to speak up to improve services.

To value inclusiveness and respect individual and team differences.

To embrace continuous learning and self-development.

To professionally challenge and take ownership to improve safety and change things for the better.

To strive to provide the highest possible standards of care and support.

To celebrate successes and have the courage to learn from mistakes

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When EPUT was first formed our focus was on establishing a new organisation and working with staff and people who use our services to shape the organisation. This new strategic direction aims to ensure we deliver on a wider transformation agenda over the next five years that provides high quality services at the core of the organisation. The Board have overseen the development of the new strategy and established a new Standing Committee of the Board, the Strategy and Planning Committee who led the work on this new strategy. The Board of Directors also undertook extensive work to consider the changes and challenges facing health and care services and considered what excellence looks like for the public we serve. During our recent Care Quality Commission (CQC) Well Led inspection overall the Trust was rated Good with Outstanding for mental health services for children and young people, and end of life care. We are committed to maintaining and continually improving this high standard consistently across all of our services and sharing best practice across the organisation and with other providers. We tried to engage with as many people as possible in the developing of this strategy. Our work commenced in spring of 2019 by engaging with:

Our service users and carers

Our staff

The public

Our Council of Governors We also ran an online survey to engage with as many people and stakeholders as possible as we recognise the breadth of our geography and range of services we provide. This engagement with our stakeholders has shaped our strategy, by identifying what is key to our population in Essex. The key themes which have emerged from the engagement undertaken were:

Co-production

Safety

Wellbeing

Flexibility

Support

Quality

Listening

Collaboration

Technology

Innovation

Shaping our services

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As the NHS continues to provide high quality services, and to live up to the expectations of service users and their carers, as a system partner we must have regard to the challenges and support the work being undertaken nationally. In formulating our strategy we have considered the NHS Long Term Plan, the Forward View for Mental Health, the interim People Plan, Getting it Right First Time (GIRFT) and the Lord Carter reviews. In addition the local agendas have been considered with the developments of STPs and Primary Care Networks (PCNs) and the growing influence of local authority partners. We will work in partnership to deliver high quality services to the communities we serve.

NHS Long Term Plan The NHS Long Term Plan, published in January 2019, set out a 10-year practical programme of phased improvements to NHS services and outcomes, including a number of specific commitments to invest the agreed NHS five-year revenue settlement. The Implementation Framework sets out the approach STPs/Integrated Care Systems (ICSs) are asked to take to create their five-year strategic plans. Plans will prioritise actions that will help improve the quality of, and access to, care for their local populations, with a focus on reducing local health inequalities and unwarranted variation. Ensuring that the NHS backs staff and develops a digitised NHS will be at the heart of local plans.

The NHS Long Term Plan outlines the following as key to the NHS’ success, new service model for the 21st century, action on prevention and reducing health inequalities, progress on care quality and outcomes, NHS staff getting the backing they need, digitally-enabled care to be mainstream across the NHS and taxpayers’ investment used to maximum effect.

National focus and priorities

The NHS Long Term Plan is key for the Trust and has shaped, and will continue to shape, our strategies and operational plans over the next 10 years. The key EPUT strategies this document impacts are:

Quality

IM&T

Engagement

Estates

Risk Management and Assurance

Commercial

Medicines Optimisation

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Five Year Forward View for Mental Health Following the publication of the NHS Long Term Plan NHS England issued a NHS Mental Health Implementation Plan for the period 2019 to 2024 which provides greater detail.

Interim People Plan EPUT’s Engagement Strategy, and HR and Workforce Framework reflect the direction and objectives within the Interim People Plan.

At the beginning of the year, the NHS Long Term Plan renewed a commitment to pursue the most ambitious transformation of mental health care England has ever known. The Five Year Forward View for Mental Health, published in 2016, represented a major step, securing an additional £1 billion in funding for mental health, so that an additional 1 million people could access high quality services by 2020/21.

Implementing the Five Year Forward View for Mental Health outlines the timeframes and funding to deliver the programmes of work which will transform mental health services. This direction has been adopted within the NHS Long Term Plan however most of our transformation with mental health services have been shaped by this document. Including the work completed in perinatal mental health, adult mental health: community, acute and crisis care, adult mental health: secure care pathway, Health and Justice and Suicide Prevention.

The NHS Interim People Plan sets out plans to make the NHS the best place to work by paying greater attention to why staff leave the NHS, taking action to retain existing staff and attract more people to join. It will develop a new offer for all people working in the NHS, through widespread engagement with our people and staff representatives. The plan will address how we need to develop and spread a positive inclusive person-centred leadership culture across the NHS, with a clear focus on improvement and advancing equality and inclusion.

Key to the plan is supporting and retaining existing nurses while attracting nurses from abroad, ensuring we make the most of the nurses we already have within our NHS, and developing a multi-professional and integrated workforce to deliver primary and community healthcare services is essential. Putting workforce planning at the centre of our planning processes, continuing to work collaboratively with more people planning activities devolved to local ICSs is also significant.

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Getting it Right the First Time Lord Carter Review of Mental Health and Community Services

Working with our STPs We work across three STPs, Hertfordshire and West Essex, Mid and South Essex and Suffolk and North East Essex. A summary of the priorities within each STP is detailed below along with a link to each STPs’ website. Every STP is due to publish their full plans in November 2019. EPUT is a key partner in each of the systems. The transformation of services has been at the heart of our strategy since merger in April 2017 and this work continues. In line with our third strategic objective we want to be a strong partner across our three STP areas and support acute providers, primary care and local authorities in achieving each system’s (STPs’) objectives. We have joint services with both the statutory and voluntary sectors. In Essex, we have already implemented new perinatal services, supporting maternity outreach. In North East Essex we have opened a new assessment centre. In West Essex, we have been working as part of an alliance with GP Federations and Princess Alexandra NHS Trust to develop and deliver a sustainable, new model of Integrated Musculoskeletal Services (iMSK) to be contracted for a period of five years. In all of our STPs we have strong partnering and governance arrangements in place.

Getting It Right First Time (GIRFT) is designed to improve the quality of care within the NHS by reducing unwarranted variations. By tackling variations in the way services are delivered across the NHS, and by sharing best practice between Trusts, GIRFT identifies changes that will help improve care and patient outcomes, as well as delivering efficiencies such as the reduction of unnecessary procedures and cost savings. GIRFT is led by frontline clinicians who are expert in the areas they are reviewing. This means the data that underpins the GIRFT methodology is being reviewed by people who understand those disciplines and manage those services on a daily basis. This forms part of our work on Quality Improvement (QI).

The Lord Carter review into mental health Trusts and providers of community services identified critical and unwarranted variations in all key resource areas. The four important areas identified where operational improvement must be made are in relation to staff, contract specifications, technology and delivery. This review provides areas of focus for EPUT both as a partner working with others and in terms of our Quality Strategy.

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Priorities for the Suffolk and North East Essex STP

Priorities for the Mid and South Essex STP

Primary Care Networks

Place more emphasis on prevention in order to keep residents living well and staying independent for as long as possible

Simplify the referral route from GPs to a whole range of health and care support

Enable our three main hospitals – Southend, Mid Essex and Basildon – to work together as one hospital to deliver more specialised care and better manage the needs of local people

Helping people to make the right choices about their health, living as independently as possible and accessing support at the right time and place.

Improving support to people through partnerships with district councils, third sector, employers and community organisations.

Integrating primary, community, mental health and social care teams around defined communities and their needs.

Introducing consistent best practice pathways, supported by integrated models of delivery.

Ensuring people are admitted to hospital at the right time for the right reason, and only when hospital is the right place for them.

Putting in place support to enable people to be quickly discharged from hospital when they are ready.

Making effective and efficient use of available resources across the STP area.

Suffolk and North East Essex STP will collaborate; be innovative, and will inspire clinical and community leadership. STP partners want the best for local people.

Over the next five years the partnership will improve care for its public; the quality of services on offer; support for its workforce; and how it spends public money within budgets.

The public, clinicians, the voluntary sector and other partners expect the partnership to join forces to reduce duplication, inefficiency and make services easier to navigate.

By linking up services, the public will see GP surgeries, mental health and social care services, acute hospitals and community health professionals all working together, moving care closer to people’s homes and improving their outcomes

PCNs form a key building block of the NHS Long Term Plan. Bringing general practices together to work at scale has been a policy priority for some years for a range of reasons, including improving the ability of practices to recruit and retain staff; to manage financial and estates pressures; to provide a wider range of services to patients and to more easily integrate with the wider health and care system. These networks will have increasing influence for the delivery of PLACE based care (populations of 30-50,000) and we will work closely with the PCNs to provide greater support in primary care and alleviate pressure on hospital services.

Priorities for the Hertfordshire and West Essex STP

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We believe that we provide good quality care now, however, when EPUT was created in 2017 we made a firm commitment that we would deliver outstanding quality care by 2022. Outstanding quality care is effective and safe and provides an excellent experience for the people using our services. It is supported by robust leadership and is provided within the resources available. It is an ambitious goal. However, we believe we can succeed by going forward together and keeping a relentless focus on quality in everything that we do.

EPUT’s Quality Strategy shows how this outstanding quality ambition is a golden thread for our services. It is central to our strategic objectives and reflected in our vision and values. It has been developed to enable us to deliver against the CQC’s five domains of being safe, effective, caring, responsive and well led as shown below:

EPUT Quality Domains

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To continuously improve service user experience and outcomes through the delivery of high quality, safe, and innovative services

Strategic objective 1

We asked our staff and stakeholders what EPUT should focus on to achieve this objective and they said:

• Improved communication

• Staffing levels

• Improved technology

• Listening to patients, service users and carers

• Innovation and quality improvements

• Co-production

We asked our staff and stakeholders to give us their views, either with an ‘I’ statement or in general on what this objective means to them, and they said:

I will aim to empower service users

I will speak up and speak out for safety and seek innovations and quality improvements from all of my colleagues across the organisation

I will be open and reflective

I will continue to provide, safe high standard person centred care

I would love the Trust to be able to be more innovative around the treatments for my condition

Truly patient focused services with support and awareness for carers.

Opportunities to better support service users and their families through joint working, referral and signposting

Safe service for all patients

This would mean that we are providing the right care to our patients and their families and that I am proud of my role in that

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Our future transformation work to support the achievement of this objective:

The creation of specialist teams and advice and support for people with a personality disorder

Build upon our service for older people with dementia that provides greater care and support in the community

Focusing on physical healthcare for people with mental health conditions

Integrating teams by leveraging opportunities arising from the provision of community and mental health services

Integrated community wound care

Frailty care co-ordination

Developing IT to support clinicians and to enhance independence for patients and service users

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Our successful strategy will mean:

Our community teams are focused on treatment and recovery, developed

in line with NICE guidance

People who require an inpatient stay remain in hospital for the shortest

possible time

Our local hospitals will see reduced demand through alternatives

developed to reduce hospital admissions

Service users and carers will have a positive experience of our services

Compliance with national and local standards

Our service users and carers will feel listened to

Innovative approaches to gather feedback from people who use services and the public will be in place

Co-production has been embraced by the Trust

Innovative improvements to safety have been made in order for us to continue to reduce harm

We have an open culture in which all safety concerns raised by staff and people who use services are highly valued as being integral to learning and improvement

Staff participate in learning to improve safety as much as possible, including working with others in the system

QI methodologies have been implemented in the Trust and staff have been trained in them

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To be a high performing health and care organisation and in the top 25% of community and mental health Foundation Trusts

Strategic objective 2

We asked stakeholders what should EPUT focus on to achieve this objective and they said:

• Patient safety

• Faster access

• Staff retention and engagement

• Communication

• Reliable technology

• Open culture

• Better understanding of service users’ needs

We asked our staff and stakeholders to give us their views, either with an ‘I’ statement or in general on what this objective means to them, and they said:

I will create a culture of shared experience, giving space for

colleagues to open up, feel heard and feel valued

I will try to enable a culture that promotes innovation

I would feel better in the knowledge that vulnerable people are

being taken care of

That we better shape the service we provide for better outcomes

and more efficient service that suits our area's needs

Provide strategic leadership setting the end objective

Ensuring the service is providing evidence based data to show best

practice

To be involved directly in co-producing the services I use

That we get better at giving the right type of treatments first time

The Trust I use is a top performer and the services I receive will be of a high quality

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Our future transformation work to support the achievement of this objective:

Work closely with GPs and the voluntary sector in developing a wider range of services to support people with mental health conditions in primary care

Multi agency working to avoid hospital admission and facilitate discharge

Develop our organisation development agenda to support culture change

Developing IT to support clinicians

Our successful strategy will mean we are in the top 25% because:

We provide high quality services which service users and staff

would recommend to their friends and family

We are learning from incidents and achieving our safety

ambitions

We are maximising research and innovations in care to increase

patient experience

Our care is enabling better outcomes for patients.

We are financially sound and meeting targets

We have grown our services and won new contracts to sustain our organisation

We have sustained and enhanced our reputation as a recognised employer of choice

We have enabled change through innovation, integration, collaboration, transformation and productivity improvement to secure a stable future

Improved and maintained learning, leadership and development leading to enhanced opportunities for staff to progress their careers and further develop their skills to develop capabilities and build capacity for the organisation

Maintained a high level of staff satisfaction through trained, supported, healthy, resilient and diverse workforce

• Shared data with our staff to drive and support internal decision making

as well as system wide working and improvement.

• Actively pursued funded research opportunities and maintained strong connections with our universities to further improve patient care involving staff and service users.

Created a culture of mutual trust between leaders and staff.

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To be a valued system leader focused on integrated solutions that are shaped by the communities we serve

Strategic objective 3

We asked stakeholders what should EPUT focus on to achieve this objective and they said:

Access to funding

Developing services according to needs

Technological innovations

Working collaboratively with stakeholders

Open communication

Flexibility

Listening to communities

We asked our staff and stakeholders to give us their views, either with an ‘I’ statement or in general on what this objective means to them, and they said:

I will actively participate in the research, development and generating of ideas

and solutions to problems that will contribute to our trust leading the way within

local systems

I will participate in conversations and projects which keep the patient and their

community in the centre

Achieving this objective would hopefully mean a more 'balanced' system where

all fields (including non-professional staff) are valued entirely on a level field

Actively seek opportunities to work collaboratively with external partners on a

project

A better community focused service

Truly integrated services meaning better use of resources and better

outcomes/experiences for residents

Work to establish a better relationship with primary care

A better understanding of the communities that we work in/with

A more integrated service with shared responsibility and outcomes, which

would lead to a more empowered workforce with a greater skill set

Staff who are delivering care and patients receiving care have a greater means

of influencing and directing that care and are supported in doing that

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Our future transformation work to support the achievement of this objective:

Providing services as close to primary care as possible.

Develop and embed a new 24/7 urgent and emergency crisis care service.

Work closely with GPs and the voluntary sector in developing a wider range of services to support people with mental health conditions in primary care.

To develop in collaboration with other NHS partners new care models for specialist services.

Develop our out of hospital initiatives including iMSK and other long term conditions.

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Our successful strategy will mean:

Strong partnership working across our three STPs, including work with the third sector.

Our services have a leadership role in the health systems which enable partners to identify and proactively address challenges and meet the needs of the population.

Digital maturity across our systems.

Continued working with our universities to take forward research activities.

Working collaboratively as a partner to a financially sustainable and thriving STP.

Reduced health inequalities across our STPs.

Operated collaboratively and transparently to deliver high value pathways of care

across organisational barriers

Enabled easier access to psychological therapies for people who need it.

Supported people living with mental health problems to find work.

Provided easy access to 24/7 crisis care

Supported carers.

Through integration improved the physical health of those with mental illness.

Improved the physical and mental health of those suffering with long term medical

conditions.

Improved access to physical and mental services for children and young people.

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Having set the vision and strategic objectives for the next five years the Board of Directors will need to ensure that it is delivered. Monitoring of the overall strategy will be completed at the Strategy and Planning Committee quarterly and reported as part of assurance reports to Trust Board. As noted within the document the Trust has a range of strategies and frameworks which set out how we will deliver our objectives in greater detail, which are also available on our website. Progress on each of these are monitored through the appropriate Standing Committee of the Trust Board of Directors. In addition, the Trust has in place corporate objectives which are reviewed each year to ensure they remain relevant and support the achievement of our strategic objectives. These corporate objectives are supported by directorate objectives, and team and personal objectives set during employee appraisals. Our corporate and directorate objectives are monitored on a quarterly basis by the relevant standing committee of the Board. Personal and team objectives are monitored as part of the supervision process and recorded during the annual appraisal process on an individual's appraisal record. For more information please email epunft.planning@nhs.net

How will we measure success and report on our progress?

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Acronym Title

STP’s Sustainability and Transformational Partnerships

DoH Department of Health

FBC Full Business Case

FFT Friends and Family Test

iMSK Integrated Musculoskeletal Services CQC Care Quality Commission

GIRFT Getting it right first time

PCNs Primary Care Networks

ICS Integrated Care Systems

QI Quality Improvement

Glossary